Zika and abortion: will the virus prompt Latin America to rethink abortion and birth control?

Author

Professor of American Culture, Obstetrics and Gynecology, and Women's Studies; Director of the Center for Latin American and Caribbean Studies and the Brazil Initiative, University of Michigan

Disclosure statement

Alexandra Minna Stern does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

The Zika virus outbreak and its probable association with microcephaly in newborns are prompting calls to loosen Latin America’s strict abortion laws and make birth control more readily available.

Abortion is fully criminalized in six countries in the region. In El Salvador, for instance, women who have abortions can face prison. In many other countries, including Brazil and Colombia, abortion is permitted only in cases of rape, incest or fetal impairment.

As Zika raises anxieties about babies born with significant medical problems, some physicians and reproductive health advocates think the virus should create another legal exception for abortion.

Even though abortion is outlawed in much of Latin America, women still seek it out at legal and physical risk. In fact, 13 percent of maternal deaths (the fourth highest cause) in the region can be attributed to unsafe abortions.

Concern about Zika could lead to real change for reproductive health for millions of women in the region. But this can happen only if the expansion of abortion and contraception is based on human rights and reproductive health equity, not driven primarily by fears of defective babies.

A member of ‘Miles,’ an NGO supporting sexual and reproductive rights, shows pins that read ‘I support the abortion decision’ at their headquarters in Santiago, July 15, 2015.Ivan Alvarado/Reuters

In 2006, Colombia’s Constitutional Court issued Decision C-355, guaranteeing three health exceptions for abortion: when the woman’s health is endangered, when serious malformations make the fetus unviable or when the pregnancy has resulted from criminal acts such as rape or incest. The decision was based, in part, on action from two groups called Women’s Link Worldwide and La Mesa.

While that possibility is debated, officials are urging women of childbearing age to avoid pregnancy, a suggestion as problematic as it is unrealistic. Colombia has high levels of unplanned pregnancy, and birth control is expensive.

Judicial interpretation frequently invokes moral law about protecting the right to life from conception. For example, both Argentina’s Civil Code and Brazil’s Penal Code and Constitution uphold that life commences at conception. This has been invoked in a range of abortion cases.

These obstacles are why women’s rights groups and reproductive health advocates, like those who argued for exceptions in Colombia, have strategically used harm reduction and exception rationales to open wedges in ironclad abortion policies.

Where is abortion legal in Latin America?

Abortion is legal and accessible in just a few places in Latin America.

Uruguayan senators vote 17 to 14 in favor of a bill to legalize abortions during the first 12 weeks of pregnancy in Montevideo, October 17, 2012.Andres Stapff/Reuters

In 2012, Uruguay made abortion available upon request in the first 12 weeks of pregnancy, following a five-day period of reflection for the woman considering termination. Later-term abortions are permitted in instances of rape and when a women’s health is endangered.

The seeds for this change were planted in the mid-2000s with the implementation of a “harm reduction model,” which allowed women to induce abortions using drugs like Mifeprex. Although this law depended on the logic of health exception, it was passed amid increasing emphasis on health equity. Since its passage, maternal deaths due to abortion have decreased markedly in the country. Uruguay now has the third lowest maternal death rate in the Americas after Canada and the United States.

Many of the women harmed by lack of access to abortion are indigenous, low-income or live in rural areas. They may not have money nor the legal resources to obtain abortions in private clinics or to make a case for an exception based on rape or incest.

The Zika outbreak has the potential to promote change in abortion and birth control policies across Latin America. Yet these reproductive health options should not be framed simply as solutions to the latest health crisis or the specter of babies with deformities. Women need contraception and access to safe, legal abortion whether they are living in an area where Zika is active, or not.

Following the lead of Uruguay and Mexico City, framing abortion and contraception in terms of human rights and reproductive health equity could help expand access to these critical services for millions of women.